Executive - Rejections

Role & responsibilities

• Review rejected claims in billing systems to identify root causes and patterns.
• Correct and resubmit rejected claims within specified timelines to ensure prompt reimbursement.
• Communicate effectively with insurance carriers to resolve claim discrepancies and denials.
• Collaborate with billing, coding, and accounts receivable teams to prevent recurring rejections.
• Ensure compliance with payer guidelines, medical billing regulations, and company policies.
• Document resolution processes and maintain accurate records of claim rejections and follow-ups.
• Provide insights and recommendations to enhance rejection management workflows.

Preferred candidate profile

• Proficiency in RCM software and tools (e.g., Kareo, Athena, or similar platforms).
• Strong knowledge of CPT, ICD-10, and HCPCS coding standards.
• Excellent analytical and problem-solving skills with attention to detail.
• Effective communication skills to liaise with internal teams and external stakeholders.
• Familiarity with HIPAA regulations and data privacy compliance.